title: Antimüllerian hormone as a measure of reproductive function in female childhood cancer survivors.
abstract: OBJECTIVE
  To evaluate the utility of measuring antimüllerian hormone (AMH) in childhood cancer survivors to assess ovarian reserve, pubertal status, and fertility potential.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  Fifty-three female childhood cancer survivors, median age 13.9 years (range: 9-25 years) recruited at least 1 year from completion of cancer therapy.
  
  
  METHODS
  None.
  
  
  METHODS
  Serum AMH, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and estradiol measurements, pubertal/menstrual history and Tanner staging, with risk of gonadotoxicity classified as low or high based on chemotherapy agent and pelvic/abdominal radiation.
  
  
  RESULTS
  Thirty-one of the 53 patients (58%) in the cohort had diminished ovarian reserve (DOR) detected by an AMH value <1 ng/mL. We detected DOR by a FSH value of >12 IU/mL in 17 patients (32%). The patients exposed to high-risk chemotherapy or pelvic radiation were at statistically significantly higher risk for DOR as measured by their AMH level. The AMH level was also statistically significantly lower in the patients who had delayed puberty.
  
  
  CONCLUSIONS
  Using the serum gonadotropins level to screen childhood cancer survivors for ovarian failure is a suboptimal method. The AMH value identified the patients at risk for delayed puberty and those who could benefit from fertility preservation counseling, which makes AMH perhaps the optimal screening tool for assessing ovarian reserve in this population.
authors.affiliation: Division of Pediatric Endocrinology, Department of Pediatrics, University of Alabama, Birmingham, Alabama. Electronic address: alison.lunsford@ttuhsc.edu.
authors.forename: Alison J
authors.initials: AJ
authors.lastname: Lunsford
authors.affiliation: Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Alabama, Birmingham, Alabama.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Whelan
authors.affiliation: Division of Pediatric Endocrinology, Department of Pediatrics, University of Alabama, Birmingham, Alabama.
authors.forename: Kenneth
authors.initials: K
authors.lastname: McCormick
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Alabama, Birmingham, Alabama.
authors.forename: Janet F
authors.initials: JF
authors.lastname: McLaren
mesh_terms: D000293:Adolescent; D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects; D015415:Biomarkers / Q000097:blood; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D009369:Neoplasms / Q000097:blood* / Q000453:epidemiology / Q000628:therapy; D010049:Ovarian Diseases / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D010053:Ovary / Q000187:drug effects / Q000378:metabolism* / Q000528:radiation effects; D011628:Puberty, Delayed / Q000097:blood* / Q000188:drug therapy / Q000453:epidemiology; D012098:Reproduction / Q000502:physiology*; D017741:Survivors; D055815:Young Adult
chemical_list: D018931:Antineoplastic Agents, Hormonal; D015415:Biomarkers; D054304:Anti-Mullerian Hormone
keywords: Antimüllerian hormone; cancer; gonadotoxicity; ovarian failure; ovarian reserve